Cyclocryotherapy in the treatment of advanced glaucoma

Cyclocryotherapy in the treatment of aphakic open-angle glaucoma (AO), aphakic angle-closure glaucoma (ACL), and neovascular glaucoma (NVG) was evaluated in 96 eyes of 96 patients. All patients had follow-up of greater than 12 months, with a mean of 29.0 +/- 2.1 months (+/- SEM). Intraocular pressure (IOP) was lowered to less than 21 mmHg in 76% of eyes with AO, 68% of eyes with ACL, and 55% of eyes with NVG. Patients with NVG lost vision more frequently (70%) than patients with AO (41%) or ACL (41%). Patients with NVG had a higher incidence of loss of light perception and phthisis bulbi than patients with ACL (P less than 0.015). In patients having visual field examinations (76/96), glaucomatous field loss was arrested in 71% of patients with AO and 65% of patients with ACL, compared to 29% of patients with NVG (P less than 0.025). There was a significant correlation between postoperative IOP less than 21 mmHg and preservation of visual field. Patients receiving initial 360 degrees cryosurgical treatment required fewer repeat treatments than patients receiving initial 180 degrees treatment (P = 0.004); complications were slightly more common in the 360 degrees group.